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Hospital Particular Gambelas

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Madeira Medical Center

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Dr. Ilídio Gonçalves

Otorrinolaringologista

Dr. Luís Dores

Otorrinolaringologista

Balloon dilation
New treatment in chronic sinusitis

HPA Magazine 8


WHAT IS CHRONIC SINUSITIS?
Chronic sinusitis is a common condition in which the cavities around nasal passages (sinuses) become inflamed and swollen for at least 12 weeks, despite treatment attempts. This condition interferes with drainage and ventilation causing mucus buildup, inflammation and infection. The most frequent symptoms are: nasal obstruction or congestion, causing difficulty breathing through your nose; discharge from the nose or drainage down the back of the throat; pain and tenderness around your eyes, cheeks, nose or forehead; reduced sense of smell and taste in adults or cough in children.

WHY DO I HAVE CHRONIC SINUSITIS?
Chronic sinusitis is a chronic inflammation of the sinuses that can occur in patient with or without allergies. So, it can be brought on by allergies, an infection, by growths in the sinuses (nasal polyps) or by a deviated nasal septum. The inferior turbinates are breathing structures inside the nose, than can become chronic inflamed and be responsible for your long term nose problems. The condition most commonly affects young and middle-aged adults, but it also can affect children.

ENT APPOINTMENT, WHEN?
You should schedule an appointment with an ENT specialist if: you've had various sinusitis episodes; you have sinusitis symptoms that last more than seven days; your symptoms don't improve after you see your doctor; if your symptoms persist for more than 12 weeks.

WHO CAN BENEFIT FROM SINUS SURGERY?
Currently, there are three options available in the treatment of chronic sinusitis: medical therapy, conventional endoscopic sinus surgery and balloon sinus dilation.
We will always attempt medical therapy in first instance for the treatment of your sinusitis. This therapy is directed toward controlling predisposing factors, treating concomitant infections, reducing edema and facilitating the drainage of sinus secretions. For this purpose we can prescribe nasal saline irrigation, topic and systemic steroids and, in some cases, antibiotics. If we fail to completely restore the sinus function and control the symptoms, you might be referred for surgery. Patients with acute sinusitis complications may also need urgent sinus surgery.
Our team is dedicated to the nose and sinus treatment/surgery, including septoplasty, turbinoplasty, all sinus surgery procedures and rhinoplasty (nose job).
As we offer a various number of surgical procedures you can discuss all available options with your doctor. Recently we introduced a new concept of surgery, the balloon sinus dilation.

WHAT IS BALLOON SINUS DILATION?
Balloon Sinus Dilation (BSD) - is a cutting-edge surgical procedure indicated for the treatment of chronic sinusitis non-responsive to medical treatment. The procedure has his foundations on the long term use of balloon dilations in the cardiovascular area for the treatment of coronary disease, in acute myocardial infarction and chronic heart disease. 
Much like angioplasty is used to open coronary arteries and avoid heart surgery, BSD offers patients with chronic sinusitis the possibility of complete preservation and restoration of the native sinus anatomy.

HOW IS IT DONE?
The procedure can be done under local anesthesia, in doctor´s office or operating room. Some patients are only eligible for procedures done under general anesthesia. 
The balloon sinus dilation is performed with the use of an endoscope and visualization in a monitor. Prior to the procedure you will be given local anesthesia with a sponge inside the nose and, if necessary, a small injection. When you feel comfortable your doctor will introduce the balloon in the ostium of the sinus to threat. The insuflation of the balloon will cause some pressure, but you won´t feel any pain. This takes about 5 seconds. With the use of the endoscope the doctor confirms that the sinus is open and with a small vacum clears all the chronic infection/inflammation. You can watch a video of the procedure in our website: www.mynose.space.

ADVANTAGES OF BALLOON SINUS DILATION?
Most sinus-related surgical cases can be approached by conventional functional endoscopic sinus surgery (FESS). Although FESS is a great surgical technique for the treatment of chronic sinusitis, it has some risks and post-operatively discomfort that can be avoided with balloon sinus dilation. Furthermore some patient can be operated in our outpatients clinic. This means that you can be operated under local anesthesia and be back to your normal daily activities in under 24 hours. Of course not all patients can be treated in this fashion. Determining whether you are an appropriate candidate for balloon sinus dilation will require a medical examination and evaluation by an ENT. 
Find our more in: www.mynose.space.